A groundbreaking multi-centre study has exposed a devastating financial crisis gripping Indian families seeking infertility treatment. The research reveals that a staggering nearly 90% of couples undergoing In Vitro Fertilisation (IVF) are pushed into catastrophic expenditure, plunging them into debt and despair, even when using public healthcare facilities.
The Staggering Financial Burden of Building a Family
The analysis, conducted across five major institutions, quantifies the immense burden at a time when infertility is estimated to affect between 3.9% and 16.8% of Indian couples. For a single cycle of IVF, the average out-of-pocket expenditure (OOPE) is an eye-watering ₹1.1 lakh in public hospitals and more than double that, ₹2.30 lakh, in private hospitals.
This exorbitant cost forces more than half of all couples to take loans, pushing families to the financial brink. The situation is exacerbated by a near-total lack of insurance support; a mere 5% of couples had any insurance coverage for IVF, and even that provided limited financial relief.
Public vs Private: A Lose-Lose Scenario for Patients
The study paints a grim picture of the healthcare landscape for infertility. While private hospitals naturally lead to higher direct medical costs, public facilities come with their own hidden burdens. Patients in government hospitals face significantly higher indirect and non-medical expenses, such as costs for travel, accommodation, and lost wages, making treatment a profound challenge across the board.
The financial strain is not confined to IVF alone. The study found that among couples undergoing treatment for other infertility causes like PCOS, endometriosis, tubal disease, or male-factor infertility, a significant 25% still experienced catastrophic expenditure. The median OOPE for these non-IVF treatments was ₹11,317.
A Call for Systemic Change and Policy Intervention
Conducted by the HTA Resource Hub at the Indian Council of Medical Research–National Institute for Research in Reproductive and Child Health (ICMR-NIRRCH), led by Principal Investigator Dr Beena Joshi, the study offers crucial data for policymakers. Researchers calculated the health-system cost for one IVF cycle at ₹81,332, irrespective of a hospital's efficiency.
Based on this figure, the study strongly recommends that the government's flagship health insurance scheme, the Pradhan Mantri Jan Arogya Yojana (PM-JAY), consider adopting ₹81,332 as the reimbursement package rate if IVF is added to its covered procedures. The researchers also suggest that, aligning with earlier CGHS norms and international NICE guidelines, coverage for up to three IVF cycles could be considered.
However, they note a major structural hurdle: since most infertility treatment expenses fall under outpatient department (OPD) care, PM-JAY would need to revise its current framework, which excludes OPD costs, to make any IVF coverage truly meaningful for families.
The human cost extends beyond finances. The study documented a markedly poorer quality of life among couples seeking treatment, with those undergoing IVF hit the hardest. Women reported significant levels of pain, anxiety, and depression, while men also showed increased anxiety scores.
The research was carried out at PGIMER Chandigarh, SRIHER Chennai, Maulana Azad Medical College in Delhi, SAT Hospital at Government Medical College Trivandrum, and Jawaharlal Nehru Medical College in Wardha. It involved detailed assessments of 30 IVF patients and 100 infertility patients at each site, along with exhaustive costing data from hospital records. Among IVF couples, oligospermia and tubal-factor infertility were the leading causes, while PCOS was the most common diagnosis in the non-IVF group.
